對碳青黴烯類抗生素具抗藥性的鮑氏不動桿菌感染治療建議

10.6666/ClinMed.202409_94(3).0100

徐靖浩；莊茜

多重抗藥性微生物（multidrug-resistant） ； 碳青黴烯類抗生素抗藥性（carbapenem-resistant） ； 鮑氏不動桿菌（Acinetobacter baumannii）

臨床醫學月刊

94卷3期（2024 / 09 / 27）

572 - 577

繁體中文

對碳青黴烯類抗生素具抗藥性的鮑氏不動桿菌感染（carbapenem-resistant Acinetobacter baumannii, CRAB）是臨床上處理感染時，不可避免會遇到的重大挑戰。依據美國感染症醫學會建議至少組合使用兩種有效藥物，並採用高劑量的ampicillin-sulbactam（sulbactam成分每日總劑量為6-9克），作為組合治療方案的一部分。除高劑量ampicillin-sulbactam外，還可以考慮：四環素衍生物（對minocycline具有最多的經驗，其次是tigecycline）、多黏菌素B（polymyxin B）或cefiderocol作為組合治療的選項。吸入型抗生素的使用，因有產生支氣管收縮等呼吸併發症的擔憂，且其組織穿透濃度也不明，因此不建議常規使用。

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